The Office of Administrative Law (OAL) has approved the Division of Workers’ Compensation (DWC) revised benefit notice regulations. The regulations are found in Title 8, California Code of Regulations, Sections 9810, 9811, 9812, 9813, 9814, 9815, 9881.1, and 10139.

Legislative leadership continued to change this week as the Assembly announced a new Assembly Speaker, Anthony Rendon (D-Lakewood) to replace Toni Atkins (D-San Diego) who will be termed out next year.

The California Supreme Court has ruled in South Coast Framing, Inc. v. Workers' Compensation Appeals Board that the standard of proximate cause does not apply to workers' compensation death benefit cases.

In its May 15, 2015 decision in Lee v. Silveira, the California Court of Appeal (Fifth Appellate District) held that in determining whether a defendant obtained a judgment more favorable than the compromise offer rejected by the defendant, any negotiated rate differential included in a jury's verdict should be subtracted from the judgment before it is compared to the offer to compromise.

In its decision in Albert v. Mid-Century Insurance Company, which was published on May 20, 2015, the California Court of Appeal (Second Appellate District) concluded that a homeowners liability insurance policy which promised to pay for property damage resulting from an accident did not cover the insured's deliberate trimming of her neighbor's trees.

In Kimco Staffing Services, Inc. v. The State of California, which was filed on May 8, 2015, the California Court of Appeal (Second Appellate District) held that there was a rational basis for the Legislature's passage of the statute which prohibits temporary workers compensation liability.

In California Insurance Guarantee Association v. Workers’ Compensation Appeals Board, which was filed on December 16, 2014, the California Court of Appeal (Fourth Appellate District) held that workers’ compensation medical billing disputes that were pending before a workers’ compensation judge prior to the enactment of SB 863 are not subject to provisions in SB 863 which created an independent bill review (IBR) process.

In its July 22, 2014 decision in Maslo v. Ameriprise Auto & Home Insurance, the California Court of Appeal (Second Appellate District) held that the trial court should not have dismissed a bad faith lawsuit which alleged the insurer submitted an uninsured motorist (UIM) claim to arbitration without investigating the claim.

On June 13, 2014, the California Court of Appeal (Second Appellate District, Division One) ruled in Uriate v. Scott Sales Co. that the component parts doctrine did not bar a worker’s lawsuit against manufacturers of material that went into the finished products made by the worker’s employer.

On June 12, 2014, the California Supreme Court issued a decision in Hartford Casualty Insurance Company v. Swift Distribution, Inc. which affirmed an October 29, 2012, Court of Appeal ruling that a commercial general liability policy which promised to pay for damages resulting from an advertising injury did not require the insurer to defend the insured in a lawsuit that did not allege disparagement to the plaintiff’s product.

In Global Hawk Insurance Company v. Le, which was issued on April 14, 2014, the California Court of Appeal (First Appellate District) reversed the trial court’s grant of an insurance company’s motion for summary judgment that the insurer had no duty to defend or indemnify its insured trucking company against a claim filed by an injured truck driver because the insurer’s liability policy excluded coverage for an injury to an employee.

In its March 21, 2014 decision in Ramos v. Brenntag, Inc., the California Court of Appeal (Second Appellate Disctrict, Division Four) reversed a trial court ruling that rejected a lawsuit brought by a foundry worker against companies that supplied metals and materials to the worker’s employer who operated the foundry.

In People v. Spriggs, which was filed on February 27, 2014, the California Court of Appeal (Fifth Appellate District) held that the statute which prohibits cellular phone use while driving only applies to instances when the driver is talking or listening on the cell phone.

In St. Cyr v. California FAIR Plan Association, the California Court of Appeal (Second Appellate Court) dismissed a lawsuit against the California FAIR Plan, which was filed by FAIR Plan policyholders who were paid the policy limits stated in their policies.

In its January 27, 2014, decision in American States Insurance Company v. Travelers Property Casualty Company of America, the California Court of Appeal (Second Appellate District) held that a food truck was mobile equipment which was not excluded from coverage provided by a commercial general liability (CGL) insurance policy.

The November 14, 2013 Weekly Report noted that U.S. District Court Judge George H. Wu issued an order granting a temporary restraining order on the enforcement of the $100 workers’ compensation lien activation fee that was added to the Labor Code by SB 863, the 2012 workers’ compensation reform law.

A Public Policy Institute of California poll released this week shows that 60 percent of likely voters approve of the Governor is doing. 75 percent of likely voters approve of the budget the Governor recently submitted which increases school funding and pays off some of the state’s debt.

In City of Sacramento v. Workers’ Compensation Appeals Board, which was filed on December 26, 2013 and certified for publication on January 15, 2014, the California Court of Appeal (Third Appellate District) held that determining the impairment rating for a claimant’s condition by analogy is permissible when the claimant’s condition is manifested only by his subjective expression of pain.

In its November 18, 2013, decision in Berendes v. Farmers Insurance Exchange, the California Court of Appeal (Third Appellate District) held that a pedestrian who was killed by an underinsured driver was not covered by the underinsured motorist (UIM) provision in the pedestrian’s father’s automobile insurance policies because the pedestrian was not an “insured.”

In San Diego Assemblers, Inc. v. Work Comp for Less Insurance Services, Inc., which was published on October 28, 2013, the California Court of Appeal (Fourth Appellate District) affirmed the dismissal of a lawsuit against an insurance broker for two reasons.

In Farmers Insurance Exchange v. Superior Court, which was published on October 28, 2013, the California Court of Appeal (Second Appellate District) held that a homeowners insurance policy which excluded coverage for an injury resulting from the use of a motor vehicle did not cover a negligent supervision claim involving the death of a child who was run over by a truck driven by one of the insureds.

As part of National Teen Driver Safety Week, Insurance Commissioner Dave Jones reminded parents to set a good example for teens by turning off their mobile phones, obeying the rules of the road, and being a safe and courteous driver.

In its ruling in J.R. Marketing v. Hartford Casualty Insurance Company, the California Court of Appeal ruled that an insurer is barred from maintaining a direct action against an independent counsel (Cumis counsel) for reimbursement of excessive fees charged by the independent counsel in mounting an insured’s defense.

In its September 16, 2013 decision in Mount Vernon Fire Insurance Corp. v. Oxnard Hospitality Enterprise, Inc., the California Court of Appeal (Second Appellate District, Division Three) held that the battery exclusion in an insurance liability policy applied to a case where there was no “body-to-body” contact.

In an opinion filed on August 23, 2013, the California Court of Appeal (Second Appellate District) held in Southern California Edison v. WCAB that the Workers’ Compensation Appeals Board (WCAB) should not have adopted the decision of a workers’ compensation judge (WCJ) because the judge’s decision failed to apportion the disability among causes of the disability.

In Liberty Mutual Ins. Co. v. Brookfield Crystal Cove, LLC., the California Court of Appeal (Fourth Appellate District, Division Three) concluded that the Right to Repair Act does not provide the exclusive remedy in cases where actual damage has occurred because of construction defects.

The California Court of Appeal’s (Sixth Appellate District) August 26, 2013, decision in Federal Insurance Company et al. v. MBL, Inc. relies on the well-established principle that not every reservation of rights entitles an insured to independent counsel.

On August 1, 2013, the California Supreme Court held in Zhang v. Superior Court that an insured may bring a lawsuit against an insurer based on California’s Unfair Competition Law (UCL) for insurer conduct that may violate the Unfair Insurance Practices Act (UIPA).

In an en banc decision issued on June 18, 2013, the Workers’ Compensation Appeals Board (WCAB) ruled that a football player employed by the Cincinnati Bengals who played one game for the Bengals in California had only temporary employment in California and thus was exempt from California’s workers’ compensation laws.

In Schaefer v. Elder the California Court of Appeal (Third Appellate District) held that the conflict of interest between the insurer and the insured required the appointment of an independent counsel to defend the insured in a negligence lawsuit.

On June 11, 2013, the California Court of Appeal (Fourth Appellate District, Division One) reversed a trial court’s judgment which held that a hospital had met its burden to establish an enforceable claim under the Hospital Lien Act.

In an unpublished opinion filed on May 16, 2013, the California Court of Appeal (Fourth Appellate District, Division Three) ruled in Roger v. CorVel Healthcare Corp. that a doctor who sued a workers’ compensation medical provider network (MPN) for terminating its contract with the doctor was not entitled to recover any damages from the MPN, even though the MPN failed to follow the termination procedure specified in the contract.

On May 22, 2013, the California Supreme Court gave notice that it will review a Court of Appeal decision which held that a lawsuit alleging negligence by a hospital relating to a collapsed bed rail was subject to the two-year statute of limitations for ordinary negligence rather than the one-year statute of limitations for professional negligence set forth in the Medical Injury Compensation Reform Act of 1975 (MICRA).

While California’s proposed budget is introduced in January, the figures in that proposed budget becomes more tangible in May when state revenues have actually been received and counted—a process known as “May Revise.”

In an en banc decision handed down on May 7, 2013, the Workers’ Compensation Appeal Board ruled in Martinez v. Terrazas that medical-legal expenses cannot be sought though the filing of a petition for costs under Labor Code Section 5811.

On May 8, 2013, the California Supreme Court heard oral arguments on Zhang v. Superior Court which presents the question whether an insurer may be sued under California’s Unfair Competition Law (UCL) for practices that are governed by the Unfair Insurance Practices Act (UIPA).

In a decision issued on May 1, 2013, the California Court of Appeal (Second Appellate District) ruled in Mt. Hawley Insurance Company v. Lopez that Insurance Code Section 533.5(b) did not preclude an insurer from providing it’s insured with a defense to federal criminal charges.

Guided by the California Supreme Court’s 2011 ruling in Howell v. Hamilton Meats & Provisions, Inc., the California Court of Appeal (Second Appellate District) has held that in a lawsuit seeking damages, the full amount billed for a plaintiff’s medical care is not relevant to determine future medical expenses and noneconomic damages.

The Division of Workers’ Compensation (DWC) has revised proposed regulations providing for the assessment of administrative penalties for Workers’ Compensation Information System (WCIS) reporting violations and posted them to the online forum where members of the public may review and comment on the proposal.

The California Supreme Court has announced that it will hear arguments on May 8, 2013, in San Francisco on the Court of Appeal’s 2009 decision in Zhang v. Superior Court, which held that an insurer may be sued under California’s Unfair Competition Law (UCL) for practices that are governed by the Unfair Insurance Practices Act (UIPA).

The California Court of Appeal (Sixth Appellate District) has ruled that the trial court was in error when it granted a defendant’s motion for summary judgment in a case where the plaintiff filed a negligence lawsuit against the defendant after the plaintiff received workers’ compensation benefits from the defendant’s insurer.

The California Supreme Court this week denied a petition filed by the Consumer Attorneys of California (CAOC) to depublish a Court of Appeal decision which held that the charges which an insurance company billed to its policyholders who paid their insurance in monthly installments were not part of the insurance premium.

In a decision handed down on February 27, 2013, the California Court of Appeal (Second Appellate District) ruled that a lawsuit alleging negligence by a hospital was subject to the two-year statute of limitations for ordinary negligence rather than the one-year statute of limitations for professional negligence.

The California Supreme Court gave notice this week that it will review a Court of Appeal decision which held that an insurer whose policy provided coverage for an advertising injury had no duty to defend an insured whose advertisement did not disparage the plaintiff’s product.

In a unanimous opinion filed on January 24, 2013, the California Supreme Court ruled in Aryeh v. Canon Business Solutions, Inc. that the four-year statute of limitations in California’s Unfair Competition Law (UCL) is subject to the continuous accrual doctrine which holds that a cause of action accrues each time a wrongful act occurs, triggering a new limitations period.

In an opinion published on January 24, 2013, the California Court of Appeal (Fourth Appellate District) ruled in Reichert v. State Farm that the “law or ordinance” exclusion in a homeowners insurance policy applied when the insured’s house was demolished by order of a city.

In an en banc decision handed down on January 15, 2013, the Workers’ Compensation Appeals Board (WCAB) refused to exercise jurisdiction over an Arizona Cardinal football player’s workers’ compensation claim because the player had signed employment contracts with the Cardinals which provided that claims for workers’ compensation were to be filed in Arizona.

In a 6-1 decision handed down on December 31, 2012, the California Supreme Court held that the primary assumption of risk doctrine barred a negligence lawsuit against an amusement park for an injury that occurred on a bumper car ride.

The 2016 California Legislative Session is shaping up to be busy and active with a crowded November ballot and new leadership in both houses. ACIC is sponsoring several measures to improve California's e-delivery law for auto, homeowners and workers compensation policyholders. ACIC is also sponoring a bill to make sure homeowners and renters have clear disclosure of available insurance coverage when they make their home available on a hosting platform. ACIC is actively engaged in opposing several auto insurance regulatory proposals. ACIC is also continuing to partner with the California Department of Insurance and CAL FIRE to help Californians prepare their finances for wildfires. more >